Senior Q&A: Seniors can have different reactions to medications

Thursday

Oct 11, 2012 at 10:16 AMOct 11, 2012 at 10:16 AM

By Debbie Gitner and Linda Sullivan

Q: My mother was given a narcotic pain medication to help reduce her pain. She began to sleep more, had decreased appetite and her personality changed. She was tearful, nervous and she stopped going out to see people.

I was upset that the physician ordered such a strong medicine for my mother. Is this a typical reaction to a narcotic pain medication? It was very difficult for my mother to get off the medication.

A: There are times that a narcotic medication is ordered for pain relief. It can be difficult to come off pain medications (or other classifications of medications) and all reductions need to be discussed with the physician. Some people need to go very slowly when reducing medication, with the goal of stopping the medication.

With seniors, it is always a good philosophy to move slowly on all medications. Seniors are not as active as the younger population and often do not drink enough liquids to flush the medication through the kidneys. Also, the body is slower, and studies have shown that medications get absorbed through the system at a different rate than that of a younger person.

If it is possible, try one medication at a time at a small dose, to see if there are any negative effects. If there are no negative effects, then consider increasing the medication. If two medications are started at the same time and there is a reaction, you may not know which medication is causing the reaction. Also, seniors may not need the same dose as someone who is younger and more active. It is very important to keep the physician updated of any and all changes so your mother can be on the right dose of medication for the length of time she requires the medication.

Q: My mother was diagnosed with Alzheimer’s disease. She was started on medication but she had side effects. If my mother cannot take the medication to help her disease, what will happen to her? Will the disease progress faster than if she took the medication?

A: Many people have side effects from the medications that help slow down Alzheimer’s disease. The current regime of medications does not cure the disease but will slow down the disease process and lessen the symptoms. But these medications only work for a limited time. With Alzheimer’s disease, brain dells die and new connections are not made which causes more memory loss. The medications are prescribed only to treat the symptoms related to thinking, judgment, language and memory and thought process. The medications delay worsening of the symptoms for 6-12 months on average per the Alzheimer’s Association. Other studies indicate the effects can be beneficial for a few years. Contact the Alzheimer’s Association or check out their web site for suggestions on vitamins, healthy lifestyle, etc.

Q: My father has a very long history of depression. He is again presenting with sadness, lack of appetite, and he is not sleeping well. When I brought him to his psychiatrist, he told me that my father is showing signs of memory loss, and I should take my father to a Neurologist for further testing. I do not see the memory loss and I wonder if my father has memory loss or forgetfulness because he is not eating a healthy diet (any more) and is not sleeping well. I have heard that lack of sleep and poor appetite can affect memory. Should he see a Neurologist?

A: I would have your father seen by a Neurologist who can help differentiate between depression and memory loss. Memory loss is affected by diet, sleep and stress. There is also something called normal aging forgetfulness. As we age our memories are not as sharp as they were years earlier. The Neurologist can perform some testing on your father both in the office plus can order scans to look at the brain. The CT scans or PET scans can answer your questions.

Debbie Gitner, a licensed certified social worker and certified social worker care manager, and Linda Sullivan, a registered nurse and case manager certified, are geriatric care managers and owners of ElderCare Resource Services helping families investigate, assess and choose medical and non-medical care and resources for seniors. Send questions to info@eldercareresourceservices.com or ElderCare Resources, Inc., 29 Gano Road, Marlborough, MA 01752, or call them at 508-879-7008. ElderCare Resource Services is a partnership of geriatric nurses and social workers that helps families to investigate, assess and recommend medical and non-medical care and resources for seniors.